Guest Blog: Tackling Concussions Head-On — The Potential Role for Omega-3s
The following blog was submitted by Marie Spano, MS, RD, CSCS, CSSD. Marie is a member of the Always Omega-3s Scientific Advisory Council and one of the country's leading sports nutritionists. This post was adapted, with permission, from an original article on Marie's professional blog.
Concussions are common in sports and recreation. Though considered a mild type of traumatic brain injury because they are usually not life-threatening, all concussions should be taken seriously. A single blow to the head can result in short-term loss of brain functioning or long-term changes in thinking, language, emotions and sensations including taste, touch and smell. Repeated concussions can be very dangerous and may lead to permanent changes in brain functioning or in extreme cases, death. Though widely recognized in football players, concussions happen in all sports – even in everyday activities – and they are occurring at younger ages. Athletes who have had one concussion have a greater risk (2 - 5.8 times higher) of experiencing another concussion. Multiple blows to the head may lead to chronic traumatic encephalopathy (CTE), a progressive neurodegenerative disease associated with poor memory, changes in personality, behavior, speech and gait. Posthumous examination of some former NFL players in addition to a few college football players who committed suicide revealed CTE.
Decreasing the Damaging Effects from Concussions
Anyone who experiences a blow to their head or body (a forceful blow to the body can cause the brain to shake inside the skull) should be immediately examined by a physician with experience in the evaluation and management of concussions. Though the person may say they feel fine and can continue with regular activities, symptoms of concussion do not always appear immediately and may instead be delayed for several hours. Continuing to play or perform mental tasks like studying can increase severity or symptoms and cause complications including the possibility of developing permanent brain damage.
Symptoms of concussion may include:
· Vision changes
· Memory loss
· Difficulty with coordination, clumsiness or stumbling
· Personality changes
· Slurred speech
· Delayed response to questions
· Nausea or vomiting
· Sensitivity to light and noise
· Problems sleeping
· Loss of consciousness
In addition to the symptoms that occur soon after a concussion, some people experience Post-Concussion Syndrome (PCS) days or weeks later. PCS can cause many of the same symptoms experienced after a concussion as well as trouble concentrating, apathy, depression and anxiety. Symptoms may last a few weeks. If you suspect PCS, have the patient evaluated by a psychiatrist.
In addition to rest, following a graduated return-to-play and school protocol,3and other steps you should take to treat concussions, emerging research suggests nutrition may play an important role. Certain nutrients seem to help reduce some of the damaging effects from concussions and one important category is omega-3s.
EPA and DHA Omega-3 Fatty Acids: EPA and DHA, omega-3 fatty acids found in fish and algae, increase fluidity of cell membranes, reduce inflammation and enhance cerebral blood flow (which is reduced for up to a month or longer in athletes that recover slowly). Cell membranes are like gateways allowing substances to enter cells or blocking their entry. When cell membranes are more fluid (and therefore less rigid), they perform better, opening the gate for nutrients to come in. DHA, in particular, makes up 97% of the omega-3 fatty acids in the brain and is essential for normal brain functioning. Several animal studies show EPA and DHA supplementation before or after a traumatic brain injury helps limit structural damage and decline in brain functioning.,,, ,,,
There is no clear consensus regarding optimal intake of EPA and DHA prior to or after a concussion. Given that many Americans do not eat enough fish and an estimated 75% of American diets are too low in EPA and DHA, it makes sense to start by meeting the general guidelines for recommended intake of EPA and DHA by:
· Consuming fatty fish varieties that contain high levels of omega-3s, including salmon, tuna, mackerel and herring at least twice per week;
· Take an omega-3 supplement providing EPA+DHA daily (be sure to look for high-quality fish oil, algal oil or krill oil supplements in your local grocery or health store);
· Eat and drink DHA omega-3-fortified foods and beverages, including milk, 100% juice, and yogurt.
Research has yet to identify exactly how much EPA + DHA may be helpful after a concussion. However, according to the Food & Drug Administration (FDA), doses of EPA + DHA up to 3 grams per day are considered safe.
 Concussion (Traumatic Brain Injury). Pubmed Health. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024859/
 Harmon KG, et al. American Medical Society for Sports Medicine position statement: concussion in sport. Br J Sports Med 2013;47:15-26.
 McKee AC, Cantu RC, Nowinski CJ, Hedley-Whyte T, Gavett BE, Budson AE, Santini VE, Lee H, Kubilus CA, Stern RA. Chronic Traumatic Encephalopathy in Athletes: Progressive Tauopathy following Repetitive Head Injury. J Neuropathol Exp Neurol 2009; 68(7): 709–735.
 Post-Concussion Syndrome. PubMed Health http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024860/
 Salem N Jr, Litman B, Kim HY, Gawrisch K. Mechanisms of action of docosahexaenoic acid in the nervous system. Lipids 2001; 36(9):945-59.
 Mills JD, Hadley K, Bailes J. Dietary supplementation with the omega-3 fatty acid docosahexaenoic acid in traumatic brain injury? Neurosurgery 2011;68:474–81
 Wu A, Ying Z, Gomez-Pinilla F. Omega-3 fatty acid supplementation restores mechanisms that maintain brain homeostasis in traumatic brain injury. J Neurotrauma 2007;24:1587–95
 Wu A, Ying Z, Gomez-Pinilla F. Dietary omega-3 fatty acids normalize BDNF levels, reduce oxidative damage, and counteract learning disability after traumatic brain injury in rats. J Neurotrauma 2004;21:1457–67
 Wang T, Van K, Gavitt B, Grayson J, Lu T, Lyeth B, Pichakron K. Effect of fish oil supplementation in a rat model of multiple mild traumatic brain injuries. Restor Neurol Neurosci 2013;31:647–59
 Mills JD, Bailes J, Sedney C, Hutchins H, Sears B. Omega-3 fatty acid supplementation and reduction of traumatic axonal injury in a rodent head injury model. J Neurosurg 2011;114:77–84
 Wu A, Ying Z, Gomez-Pinilla F. The salutary effects of DHA dietary supplementation on cognition, neuroplasticity, and membrane homeostasis after brain trauma. J Neurotrauma 2011;28:2113–22
 Wu A, Ying Z, Gomez-Pinilla F. Exercise facilitates the action of dietary DHA on functional recovery after brain trauma. Neuroscience 2013;248:655–63